Annals of surgery
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Randomized Controlled Trial Comparative Study
Less Pain 1 Year After TEP Compared with Lichtenstein Using Local Anesthesia: Data from a Randomized Controlled Clinical Trial.
The aim was to compare long-term postoperative pain after inguinal hernia surgery using 2 techniques that have shown favorable long-term outcome in previous randomized studies: Lichtenstein using local anesthesia (LLA) and endoscopic total extra-peritoneal repair (TEP) under general anesthesia. ⋯ Patients operated with TEP experienced less long-term postoperative pain and less limitation in their ability to exercise than those operated with LLA. The present data justify recommending TEP as the procedure of choice in the surgical treatment of primary inguinal hernia.
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Observational Study
Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-based Analysis.
To evaluate complications after postmastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy. ⋯ Complication risks after immediate breast reconstruction differ by approach. Radiation therapy seems to modestly increase certain risks, including infection and implant removal.
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To evaluate previously independent older patients discharged to skilled nursing facilities (SNFs) and identify risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. ⋯ A large proportion of older patients discharging to SNFs never return home. A better understanding of the natural history of patients sent to SNFs after hospitalization and risk factors for failure to return to home, readmission, and death should help identify opportunities for interventions to improved outcome.
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Our objectives were to (1) compare 30- and 90-day mortality rates after esophagectomy, (2) compare drivers of 30- and 90-day mortality, and (3) examine whether 90-day mortality affects hospital rankings. ⋯ Examination of 90-day mortality after esophagectomy reflects cancer patient management decisions and may provide actionable targets for quality improvement.
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Observational Study
Colorectal Cancer, Systemic Inflammation, and Outcome: Staging the Tumor and Staging the Host.
This study aims to examine the clinical utility of the combination of TNM stage and modified Glasgow Prognostic Score (mGPS) in patients undergoing potentially curative resection of colorectal cancer (CRC). ⋯ This study shows how the combination of TNM and mGPS effectively stratifies outcome in patients undergoing potentially curative resection of CRC. These data support routine staging of both the tumor and the host in patients with CRC.